I started my last day in Quy Khon at 5 am with a walk along the beach. People were up enjoying the cool breeze with volleyball and badminton.
Our last day in the operating room was filled with simpler same-day reconstructive procedures like nose revisions to fix the flattening that is common with cleft lip and palate patients. Patients with skin grafts and pins in contracted fingers repaired earlier in the trip returned for dressing changes.
The babies from the pediatric ward came down to say goodbye.
I am also team physician so I have had some patients from the team. With the heat index at 108 again today, drinking is important. I bring powdered lemonade mix to brighten up all the bottled water. Hand washing and careful eating (cook it, peel it, or forget it) are mandatory to stay healthy and work.
Tonight we have dinner with the hospital staff who have helped us the last two weeks before we take the midnight train back to Da Nang for the short flight back to Hong Kong and then the long trip back to San Francisco.
Every team I join on these trips presses me. There are many ReSurge veterans along with some newbies.
Our team leader is Dr. George Gregory, anesthesia.
We had a visit today from a little girl whose cleft lip we repaired last week. Today there were burn contractures that were grafted and repaired. Injuries from fires, cooking over open flames, electrical lines and gasoline are common.
Outside the intensive care unit families light incense while they wait for news.
Back to work. Eleven cases today. Some of the team spent the night in the hospital monitoring a toddler after a cleft pLate repair. He did well. It was past time for the dinner menu so it was a coconut and gorp for me.
Night rounds for Tuesday’s cases.
After rounding at the hospital Saturday and discharging patients, we visited the Nguyen NGA Center for Young People with Special Needs. There children with physical disabilities learn a trade like sewing, playing a musical instrument, crafts and computers.
From there we visited the Chaam Temple ruins, the memorial for poet Han Mac Tu, and a leper site before taking a quick dip in the South China Sea.
Sunday was on our own for a coffee, picking up the scrub dress I had a local seamstress make, and lastly the grocery store for some provisions for the week.
Monday’s patients were admitted to the hospital Sunday night and two new patients were evaluated for surgery.
On clinic day we also see some adults. A 58 year old farmer with a cleft lip came to be evaluated by the surgeons. He had been coming to international volunteer clinics since he was in his twenties only to be turned away because he was not a child.
Today he had his cleft lip repaired, and the scene around him when he came out of anesthesia and looked at himself in the mirror was something not soon forgotten.
Last night our evening rounds ended at 9:30 p.m.–which was 7:30 a.m. back in California. To figure out the time back home I subtract 2 from my time here and flip my p.m. to a.m. or vice versa.
This morning we cancelled two cases: one girl was wheezing and another little boy had cold symptoms. The risk of anesthesia is much higher for patients with respiratory symptoms like runny nose and cough.
On clinic day there were more patients than we had slots for so the coordinators called families and found four patients to put on the schedule–it was very good that those patients hadn’t had lunch yet!
The operation room staff keeps us going with ca phe–two fingers of thick coffee with sweetened condensed milk. The post-op nurses call it jet fuel.
The sun is setting over the mountains, off to rounds.
Today a family arrived for evaluation and their son was added to the schedule and had his cleft palate repaired.
Cleft palate is when the top of the mouth isn’t closed over.
There are a number of children with ptosis who cannot raise their eyelids and have to tilt their heads backward to see. The corrective surgery involves transplanting pieces of tendon that attach above the eyebrows.
Waking up after surgery can be difficult for the toddlers. The child-sized hammocks are very comforting places to sleep afterwards.
We have a breezy corridor for our pre-operative area where patients wait before surgery. Here they can color after they take their sedating medicine mixed with Coca Cola.
From there they go to the operation room.
After their surgical procedure is completed they come to the Recovery room.
Once they are awake and drinking they go up to the pediatric wards on the fourth floor.
Clinic wrapped up after 5 and we walked home along the South China Sea back to the hotel. An orderly day from first to last patient-I’m pretty tired too.